Maternal endothelial damage as a disorder shared by early preeclampsia, late preeclampsia and intrauterine growth restriction

Kwiatkowski, Sebastian; Dołęgowska, Barbara; Kwiatkowska, Ewa; Rzepka, Rafał; Marczuk, Natalia; Łój, Beata; Torbé, Andrzej

doi:10.1515/jpm-2016-0178

Cited by 20 publications

(11 citation statements)

References 45 publications

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“…This low birth weight was also influenced by the prevalence of IGR in this group, which in our series was 23.8%, close to the 25% found in the study by Kongwattanakul et al [15]. SP is one of the main known causes of IGR and has an OR of 2.16 (95% CI, p = 0.026) according to Liu et al Both pathologies originate from anomalous placentation, which conditions increased resistance to uteroplacental flow and placental insufficiency secondary to the endothelial destruction of a low-resistance tissue subjected to high pressure (Kwiatkowski) [16].…”

Section: Discussionsupporting

confidence: 71%

Maternal Perinatal Characteristics in Patients with Severe Preeclampsia: A Case-Control Nested Cohort Study

Moreno

Rodríguez-Benítez

Ruiz-Minaya

et al. 2021

IJERPH

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Preeclampsia is one of the most worrisome complications during pregnancy, affecting approximately 1 out of 20 women worldwide. Preeclampsia is mainly characterized by a sustained hypertension, proteinuria, also involving a significant organ dysfunction. Moreover, 25% of the cases could be classified as severe preeclampsia (SP), a serious condition that could be life-threatening for both the mother and fetus. Although there are many studies focusing on preeclampsia, less efforts have been made in SP, frequently limited to some specific situations. Thus, the present study aims to conduct a comparative analysis of risk factors, maternal characteristics, obstetric and neonatal outcomes and maternal complications in patients with severe preeclampsia versus patients without severe preeclampsia. Hence, 235 cases and 470 controls were evaluated and followed in our study. We described a set of variables related to the development of severe preeclampsia, including maternal age > 35 years (69.8%), gestational (26.8%) or chronic arterial hypertension (18.3%), obesity (22.6%), use of assisted reproduction techniques (12.3%), prior history of preeclampsia (10.2%) and chronic kidney disease (7.7%) All patients had severe hypertension (>160 mmHg) and some of them presented with additional complications, such as acute renal failure (51 cases), HELLP syndrome (22 cases), eclampsia (9 cases) and acute cerebrovascular accidents (3 cases). No case of maternal death was recorded, although the SP group had a higher cesarean section rate than the control group (60% vs. 20.9%) (p < 0.001), and there was a notably higher perinatal morbidity and mortality in these patients, who had a prematurity rate of 58.3% (p < 0.001) and 14 perinatal deaths, compared to 1 in the control group. Overall, our study recognized a series of factors related to the development of SP and related complications, which may be of great aid for improving the clinical management of this condition.

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Section: Discussionsupporting

confidence: 71%

Maternal Perinatal Characteristics in Patients with Severe Preeclampsia: A Case-Control Nested Cohort Study

Moreno

Rodríguez-Benítez

Ruiz-Minaya

et al. 2021

IJERPH

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“…Several biomarkers of PE, including vascular endothelial growth factor (VEGF), placental growth factor (PlGF), and soluble Flt-1, are involved in angiogenesis. In pregnant women with PE and/or IUGR, higher concentrations of soluble Flt-1 and lower concentrations of PlGF were found compared to the controls [23]. Low levels of angiogenic proteins on the first postnatal day in infants delivered on fetal or maternal indication due to IUGR and PE were found in the ELGAN study [24].…”

Section: Discussionmentioning

confidence: 89%

Reduced Prevalence of Severe Intraventricular Hemorrhage in Very Preterm Infants Delivered after Maternal Preeclampsia

2018

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Background: Very preterm (VPT) delivery after severe preeclampsia (PE) has been associated with adverse perinatal outcome. It is unclear whether fetal exposure to PE per se modifies the prevalence of neonatal morbidities associated with VPT birth. Objectives: To evaluate neonatal morbidity in VPT infants exposed to maternal PE compared to morbidity in nonexposed VPT infants. Methods: This retrospective study consisted of all inborn infants delivered before 30 gestational weeks admitted to a tertiary-level neonatal intensive care unit between 1998 and 2014: 195 infants exposed to maternal PE were compared to 957 infants without maternal PE (background group). Prevalence rates of neonatal morbidity, cerebral palsy (CP), and mortality at 2 years of age were obtained from patient records. Results: The PE group had a lower median (IQR) birth weight (795 [262] g) and a higher median gestational age (GA) (27 [3] weeks) at birth than the background group (890 [385] g and 26 [3] weeks, respectively; both p < 0.001). Exposure to maternal PE was associated with lower rates of severe intraventricular hemorrhage (IVH) (2 vs. 11%), retinopathy of prematurity requiring treatment (2 vs. 7%), mortality (9 vs. 15%), and CP (4 vs. 8%). Exposure to PE remained associated with a reduced prevalence of severe IVH (OR 0.17, 95% CI 0.05–0.57) after adjustment for GA, multiple birth, Apgar score, delivery mode, sex, and antenatal steroid treatment. Conclusion: Fetal exposure to PE is associated with a decreased rate of severe IVH following VPT birth. Studies on underlying mechanisms may provide a basis for prevention of IVH in the VPT infant.

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“…Maternal vitamin D deficiency has been linked to pregnancy complications, including preeclampsia [18,19], preterm birth [20], and intrauterine growth restriction [21], which may promote adverse neonatal outcomes, such as increased future risk of hypertension [22], enteritis [23], asthma [24], and impaired neurodevelopment [25]. Meanwhile, intrauterine/placental inflammation also has been linked to the abovementioned pregnancy-related complications [26] and adverse neonatal outcomes [27], suggesting the possibility of an association between maternal vitamin D deficiency and intrauterine/placental inflammation. Previous reports on the association between vitamin D deficiency and placental function were mostly based on animal studies and showed that vitamin D could inhibit placental inflammation by activating the vitamin D receptor (VDR)/nuclear factor kappa B pathway [28e30], but the evidence is lacking in humans [31,32].…”

Section: Introductionmentioning

confidence: 99%

Severe vitamin D deficiency in the first trimester is associated with placental inflammation in high-risk singleton pregnancy

et al. 2019

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Maternal endothelial damage as a disorder shared by early preeclampsia, late preeclampsia and intrauterine growth restriction

Cited by 20 publications

References 45 publications

Maternal Perinatal Characteristics in Patients with Severe Preeclampsia: A Case-Control Nested Cohort Study

Maternal Perinatal Characteristics in Patients with Severe Preeclampsia: A Case-Control Nested Cohort Study

Reduced Prevalence of Severe Intraventricular Hemorrhage in Very Preterm Infants Delivered after Maternal Preeclampsia

Severe vitamin D deficiency in the first trimester is associated with placental inflammation in high-risk singleton pregnancy

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